Provider Demographics
NPI:1649760273
Name:GRIGORYEVA, OLGA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:GRIGORYEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26600 RENAISSANCE PKWY
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5795
Mailing Address - Country:US
Mailing Address - Phone:216-329-8999
Mailing Address - Fax:
Practice Address - Street 1:26600 RENAISSANCE PKWY
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5795
Practice Address - Country:US
Practice Address - Phone:216-329-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator